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User-Innovated eHealth Solutions for Service Delivery to Older Persons With Hearing Impairment.

ABSTRACT: Purpose:The successful design and innovation of eHealth solutions directly involve end users in the process to seek a better understanding of their needs. This article presents user-innovated eHealth solutions targeting older persons with hearing impairment. Our research question was: What are the key users' needs, expectations, and visions within future hearing rehabilitation service delivery? Method:We applied a participatory design approach to facilitate the design of future eHealth solutions via focus groups. We involved older persons with hearing impairment (n = 36), significant others (n = 10), and audiologists (n = 8) following 2 methods: (a) human-centered design for interactive systems and (b) user innovation management. Through 3 rounds of focus groups, we facilitated a process progressing from insights and visions for requirements (Phase 1), to app such as paper version wireframes (Phase 2), and to digital prototypes envisioning future eHealth solutions (Phase 3). Each focus group was video-recorded and photographed, resulting in a rich data set that was analyzed through inductive thematic analysis. Results:The results are presented via (a) a storyboard envisioning future client journeys, (b) 3 key themes for future eHealth solutions, (c) 4 levels of interest and willingness to invest time and effort in digital solutions, and (d) 2 technical savviness types and their different preferences for rehabilitation strategies. Conclusions:Future eHealth solutions must offer personalized rehabilitation strategies that are appropriate for every person with hearing impairment and their level of technical savviness. Thus, a central requirement is anchoring of digital support in the clients' everyday life situations by facilitating easy access to personalized information, communication, and learning milieus. Moreover, the participants' visions for eHealth solutions call for providing both traditional analogue and digital services. Supplemental Material:https://doi.org/10.23641/asha.7310729.

SUBMITTER: Nielsen AC

PROVIDER: S-EPMC6437709 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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User-Innovated eHealth Solutions for Service Delivery to Older Persons With Hearing Impairment.

Nielsen Annette Cleveland AC Rotger-Griful Sergi S Kanstrup Anne Marie AM Laplante-Lévesque Ariane A

American journal of audiology 20181101 3S

<h4>Purpose</h4>The successful design and innovation of eHealth solutions directly involve end users in the process to seek a better understanding of their needs. This article presents user-innovated eHealth solutions targeting older persons with hearing impairment. Our research question was: What are the key users' needs, expectations, and visions within future hearing rehabilitation service delivery?<h4>Method</h4>We applied a participatory design approach to facilitate the design of future eH ...[more]

PMID: 30452745

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Project description:BackgroundService model design is slowly being recognized among eHealth developers as a valuable method for creating durable implementation strategies. Nonetheless, practical guidelines and case-studies that inform the community on how to design a service model for an eHealth innovation are lacking. This study describes the development of a service model for an eHealth service, titled 'SALSA', which intends to support older adults with a physically active and socially inclusive lifestyle.MethodsThe service model for the SALSA service was developed in eight consecutive rounds, using a mixed-methods approach. First, a stakeholder salience analysis was conducted to identify the most relevant stakeholders. In rounds 2-4, in-depth insights about implementation barriers, facilitators and workflow processes of these stakeholders were gathered. Rounds 5 and 6 were set up to optimize the service model and receive feedback from stakeholders. In rounds 7 and 8, we focused on future implementation and integrating the service model with the technical components of the eHealth service.ResultsWhile the initial goal was to create one digital platform for the eHealth service, the results of the service modelling showed how the needs of two important stakeholders, physiotherapists and sports trainers, were too different for integrating them in one platform. Therefore, the decision was made to create two platforms, one for preventive (senior sports activities) and one for curative (physical rehabilitation) purposes.ConclusionsA service model shows the interplay between service model design, technical development and business modelling. The process of service modelling helps to align the interests of the different stakeholders to create support for future implementation of an eHealth service. This study provides clear documentation on how to conduct service model design processes which can enable future learning and kickstart new research. Our results show the potential that service model design has for service development and innovation in health care.

Project description:BackgroundThe assessment of usability is a complex process that involves several steps and procedures. It is important to standardize the evaluation and reporting of usability procedures across studies to guide researchers, facilitate comparisons across studies, and promote high-quality usability studies. The first step to standardizing is to have an overview of how usability study procedures are reported across the literature.ObjectiveThis scoping review of reviews aims to synthesize the procedures reported for the different steps of the process of conducting a user-centered usability assessment of digital solutions relevant for older adults and to identify potential gaps in the present reporting of procedures. The secondary aim is to identify any principles or frameworks guiding this assessment in view of a standardized approach.MethodsThis is a scoping review of reviews. A 5-stage scoping review methodology was used to identify and describe relevant literature published between 2009 and 2020 as follows: identify the research question, identify relevant studies, select studies for review, chart data from selected literature, and summarize and report results. The research was conducted on 5 electronic databases: PubMed, ACM Digital Library, IEEE, Scopus, and Web of Science. Reviews that met the inclusion criteria (reporting on user-centered usability evaluation procedures for any digital solution that could be relevant for older adults and were published in English) were identified, and data were extracted for further analysis regarding study evaluators, study participants, methods and techniques, tasks, and test environment.ResultsA total of 3958 articles were identified. After a detailed screening, 20 reviews matched the eligibility criteria. The characteristics of the study evaluators and participants and task procedures were only briefly and differently reported. The methods and techniques used for the assessment of usability are the topics that were most commonly and comprehensively reported in the reviews, whereas the test environment was seldom and poorly characterized.ConclusionsA lack of a detailed description of several steps of the process of assessing usability and no evidence on good practices of performing it suggests that there is a need for a consensus framework on the assessment of user-centered usability evaluation. Such a consensus would inform researchers and allow standardization of procedures, which are likely to result in improved study quality and reporting, increased sensitivity of the usability assessment, and improved comparability across studies and digital solutions. Our findings also highlight the need to investigate whether different ways of assessing usability are more sensitive than others. These findings need to be considered in light of review limitations.

Project description:Introduction: As the prevalence of age-related sensory impairment increases, more evidence emerges on the association between uni-sensory and cognitive impairment (CI) in older adults. However, the link between CI and concurrent hearing and vision impairment (referred to as dual sensory impairment/DSI) is not well-understood, and this combined effect may be additive or multiplicative. Moreover, the existing evidence on CI in older adults with DSI is scattered and limited. Through this systematic scoping review, we aim to map existing evidence on CI in older adults with DSI, and to summarize what is known about the prevalence, incidence and risk factors of CI, and tools used to screen or assess CI in older adults with DSI. Methods and Analysis: We will use the Joanna Briggs Institute framework to perform the review. Eleven databases [MEDLINE, CINAHL/EBSCO, EMBASE, Mednar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey (SIGLE), Global Health, PsycINFO, and Web of Science] and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Study selection will be completed using Covidence, and data will be extracted using an a priori data extraction tool. To be included, studies had to be peer-reviewed, had older adults with DSI as the focal population, and are related to CI. Data will be presented using a narrative summary with emphasis on implications for future research and practice. Discussion: Reliable cognitive screening is of the utmost importance for prevention and treatment of CI within DSI population. The study findings will have significant implications for health services delivery and policy research. The summarized findings on the prevalence, incidence, associated risk factors, and CI screening and assessment tools will inform geriatric care. The review will also document knowledge gaps on CI in the DSI population and identify areas of interest for future studies. Ethics and Dissemination: The scoping study, being a review of existing documents, does not require ethics approval. The findings will be disseminated with relevant stakeholders using knowledge translation activities such as scientific presentations and publications. We intend to use the findings to conduct a Delphi study to evaluate which CI tools are suitable for older population with DSI.

Project description:BackgroundAcross eHealth intervention studies involving children, adolescents, and their parents, researchers have measured user experience to assist with intervention development, refinement, and evaluation. To date, no widely accepted definitions or measures of user experience exist to support a standardized approach for evaluation and comparison within or across interventions.ObjectiveWe conduct a scoping review with subsequent Delphi consultation to identify how user experience is defined and measured in eHealth research studies, characterize the measurement tools used, and establish working definitions for domains of user experience that could be used in future eHealth evaluations.MethodsWe systematically searched electronic databases for published and gray literature available from January 1, 2005, to April 11, 2019. We included studies assessing an eHealth intervention that targeted any health condition and was designed for use by children, adolescents, and their parents. eHealth interventions needed to be web-, computer-, or mobile-based, mediated by the internet with some degree of interactivity. We required studies to report the measurement of user experience as first-person experiences, involving cognitive and behavioral factors reported by intervention users. We appraised the quality of user experience measures in included studies using published criteria: well-established, approaching well-established, promising, or not yet established. We conducted a descriptive analysis of how user experience was defined and measured in each study. Review findings subsequently informed the survey questions used in the Delphi consultations with eHealth researchers and adolescent users for how user experience should be defined and measured.ResultsOf the 8634 articles screened for eligibility, 129 articles and 1 erratum were included in the review. A total of 30 eHealth researchers and 27 adolescents participated in the Delphi consultations. On the basis of the literature and consultations, we proposed working definitions for 6 main user experience domains: acceptability, satisfaction, credibility, usability, user-reported adherence, and perceived impact. Although most studies incorporated a study-specific measure, we identified 10 well-established measures to quantify 5 of the 6 domains of user experience (all except for self-reported adherence). Our adolescent and researcher participants ranked perceived impact as one of the most important domains of user experience and usability as one of the least important domains. Rankings between adolescents and researchers diverged for other domains.ConclusionsFindings highlight the various ways in which user experience has been defined and measured across studies and what aspects are most valued by researchers and adolescent users. We propose incorporating the working definitions and available measures of user experience to support consistent evaluation and reporting of outcomes across studies. Future studies can refine the definitions and measurement of user experience, explore how user experience relates to other eHealth outcomes, and inform the design and use of human-centered eHealth interventions.

Project description:ObjectivesThe objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models.DesignThe design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups.SettingOlder adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic.ParticipantsParticipants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention.Intervention(s)All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model.Primary and secondary outcome measuresPrimary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained.ResultsPer-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p < .05) lower satisfaction and percentage (CD: 55%; AB: 81%; P: 36%) likely to purchase hearing aids after the trial.ConclusionsHearing aids are efficacious in older adults for both AB and CD service-delivery models. CD model of OTC service delivery yielded only slightly poorer outcomes than the AB model. Efficacious OTC models may increase accessibility and affordability of hearing aids for millions of older adults. Purchase price had no effect on outcomes, but a high percentage of those who rejected hearing aids paid the typical price (85%).Trial registrationClinicaltrials.gov: NCT01788432; https://clinicaltrials.gov/ct2/show/NCT01788423.

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User-Innovated eHealth Solutions for Service Delivery to Older Persons With Hearing Impairment.

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User-Innovated eHealth Solutions for Service Delivery to Older Persons With Hearing Impairment.

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